Edgewood Manor Nursing Home - Raytown Nursing Home
General Information
UPDATEFederal Provider Number
265425
Provider Name
EDGEWOOD MANOR NURSING HOME
Provider Address
11900 JESSICA LANE
RAYTOWN, MO 64138
RAYTOWN, MO 64138
Provider Phone Number
8163587858
Provider SSA County
470
Provider County Name
Jackson
Ownership Type
For profit - Limited Liability
Number of Certified Beds
66
Number of Residents in Certified Beds
56
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
PHEM, LLC
Date First Approved to Provide Medicare and Medicaid services
1990-04-12
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Resident
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
1
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
1
Staffing Rating Footnote
RN Staffing Rating
2
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
1.86071
Reported LPN Staffing Hours per Resident per Day
0.69911
Reported RN Staffing Hours per Resident per Day
0.48750
Reported Licensed Staffing Hours per Resident per Day
1.18661
Reported Total Nurse Staffing Hours per Resident per Day
3.04732
Reported Physical Therapist Staffing Hours per Resident Per Day
0.11696
Expected CNA Staffing Hours per Resident per Day
2.19854
Expected LPN Staffing Hours per Resident per Day
0.59918
Expected RN Staffing Hours per Resident per Day
0.97858
Expected Total Nurse Staffing Hours per Resident per Day
3.77630
Adjusted CNA Staffing Hours per Resident per Day
2.07667
Adjusted LPN Staffing Hours per Resident per Day
0.96842
Adjusted RN Staffing Hours per Resident per Day
0.37223
Adjusted Total Nurse Staffing Hours per Resident per Day
3.25278
Cycle 1 Total Number of Health Deficiencies
8
Cycle 1 Number of Standard Health Deficiencies
8
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
48
Cycle 1 Standard Survey Health Date
2015-01-27
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
48
Cycle 2 Total Number of Health Deficiencies
10
Cycle 2 Number of Standard Health Deficiencies
10
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
60
Cycle 2 Standard Health Survey Date
2014-01-09
Cycle 2 Number of Health Revisits
2
Cycle 2 Health Revisit Score
30
Cycle 2 Total Health Score
30
Cycle 3 Total Number of Health Deficiencies
10
Cycle 3 Number of Standard Health Deficiencies
10
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
76
Cycle 3 Standard Health Survey Date
2013-02-07
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
76
Total Weighted Health Survey Score
66.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
2
Number of Fines
0
Total Amount of Fines in Dollars
0
Number of Payment Denials
0
Total Number of Penalties
0
Location
Processing Date
2015-06-01
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